| NPI | 1780900845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist (Licence: AZ 62589) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: MA 258385) |
| 207WX0107X Ophthalmology, Retina Specialist (Licence: MA 258385) | |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2021-05-14 |